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Parkinson's nausea treatment — GPhC CRA MCQ

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HardCNS TherapeuticsParkinson's nausea treatmentGPhC CRA

A 77-year-old woman with Parkinson's disease taking co-beneldopa is nauseated after a dose increase. A junior doctor suggests metoclopramide and asks for pharmacy advice. What is the most appropriate alternative?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Domperidone with appropriate risk assessment

Dopamine-blocking antiemetics such as metoclopramide, prochlorperazine and haloperidol can worsen Parkinsonism. Domperidone is less likely to cross the blood-brain barrier but has cardiac risks and should be used with appropriate caution. The best option depends on patient-specific QT and cardiac risk. Pharmacy advice should prevent worsening of motor symptoms.

Reference: BNF; NICE CKS